Making house calls increases living donor inquiries and evaluations for blacks on the kidney transplant waiting list.
Making house calls increases living donor inquiries and evaluations for blacks on the kidney transplant waiting list.
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DOI：
10.1097/tp.0000000000000165
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发表时间：
2014-11-15
期刊：
影响因子：
6.2
通讯作者：
Mandelbrot DA
中科院分区：
文献类型：
--
作者：
Rodrigue JR;Paek MJ;Egbuna O;Waterman AD;Schold JD;Pavlakis M;Mandelbrot DA
黑人接受活体供肾移植(LDKT)的频率低于所有其他种族的患者。我们评估了教育干预措施在消除黑人学习障碍方面的有效性。患者被随机分为三种干预措施，其中健康教育者(S)在患者家中对患者和他/她的客人进行干预(出诊，HC n=54)，(B)在移植中心成群的患者和他们的客人(组群，GB n=49)，(C)单独在移植中心的患者(个人咨询，IC n=49)。在2年终点，分别有15%(8)、8%(4)和6%(3)的HC、GB和IC患者接受了LDKT(p=0.30)。HC患者比GB和IC患者更有可能至少有一次捐赠者咨询(82%比61%比47%，p=0.001)和评估(65%比39%比27%，p<；0.001)。在干预6周后，HC患者也更有可能有更高的知识，更少的担忧，以及更愿意与他人谈论捐献事宜。这些发现强调了将患者的社会网络包括在LDKT教育中的重要性，以及HC干预降低LDKT发生率的种族差异的潜力。
Blacks receive live donor kidney transplantation (LDKT) less often than patients of all other races. We evaluated the effectiveness of educational interventions in removing barriers to LDKT for blacks. Patients were randomized to three interventions in which health educator(s) delivered an intervention to (a) the patient and his/her guests in the patient’s home (House Calls, HC n=54), (b) clusters of patients and their guests in the transplant center (Group-Based, GB n=49), (c) the individual patient alone in the transplant center (Individual Counseling, IC n=49). At the 2-year endpoint, 15% (8), 8% (4), and 6% (3) of HC, GB, and IC patients, respectively, received LDKT (p=0.30). HC patients were more likely than GB and IC patients to have at least one donor inquiry (82% vs. 61% vs. 47%, p=0.001) and evaluation (65% vs. 39% vs. 27%, p<0.001). HC patients also were more likely to have higher knowledge, fewer concerns, and higher willingness to talk to others about donation 6 weeks post- intervention. These findings underscore the importance of including the patient’s social network in LDKT education and the potential of the HC intervention to reduce racial disparity in LDKT rates.